Address of Witness. ~SIGNATURE OF RELEVANT PERSON ................................................................................................................................
Address of Witness. GUARANTOR’S ACKNOWLEDGEMENT & SIGNATURE
Address of Witness. By executing this agreement the attorney states .......................................... ) that the attorney has received no notice of Occupation of witness ) revocation of the power of attorney )
Address of Witness. Executed on behalf of QUOTIENT BIOCAMPUS LIMITED by ........................................................ (signature) Full Name:........................................................ Director/Company Secretary/Authorised Signatory* at...................................................................... on .................................................................... * Please delete as applicable In the presence of this witness: Witness' Signature: ........................................................................ Full name of witness: ........................................................................
Address of Witness. By executing this deed the attorney ) states that the attorney has received no .................................. ) notice of revocation of the power of Occupation of witness ) attorney
Address of Witness. DATE …………………………………………………………………………………………………………………………….
Address of Witness. Address of Authorised Officer DATED / / 2017 EXECUTED by THE AUSTRALIAN SALARIED MEDICAL OFFICERS’ FEDERATION NEW SOUTH WALES by being signed by those persons who are authorised to sign on its behalf: ) ) ) ........................................................................... … ..................................................................................... Witness ..................................................................................... Name of Authorised Officer .....................................................................................
Address of Witness. Occupation: ................................................... EXECUTED and DELIVERED as a DEED ) by INLAND HELIX LIMITED acting by a )….............................................. director in the presence of: ) Witness Signature: ...................................................
Address of Witness. Signed by me (the Customer).
Address of Witness. Occupation: ...................................................
